ORIGINAL PAPER
Potential application of stereotactic radiotherapy in head and neck cancer
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1
Radiotherapy Department, Oncology Center – Prof. Franciszek Lukaszczyk Memorial Hospital, Bydgoszcz, Poland
2
Chair and Clinic of Oncology and Brachytherapy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
3
Academy of Applied Medical and Social Sciences, Elbląg, Poland
Submission date: 2024-11-06
Acceptance date: 2024-12-30
Online publication date: 2024-12-31
Publication date: 2024-12-31
Corresponding author
Marta Biedka-Paluch
Radiotherapy Department, Oncology Center – Prof. Franciszek Lukaszczyk Memorial Hospital, Romanowskiej 2, 85-796 Bydgoszcz, Poland. Tel. +48 605 478 745.
Acta Elbingensia 2024;51(1):14-22
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Stereotactic ablative radiation (SABR) therapy, or stereotactic body radiation therapy (SBRT), delivers high-dose external beam radiation to a small, clearly defined target area in one or more sessions. It is the standard treatment for medically inoperable early-stage non-small cell lung cancer, early-stage prostate cancer, and oligometastatic disease from other primary locations.
Aim:
This article discusses the use of stereotactic radiotherapy in neoplasms of the head and neck region – as primary treatment, including early laryngeal cancer; as post-operative adjuvant therapy; as a boost after radiation therapy (dose escalation method); and the use of SBRT for re-radiatiotherapy. The next part discusses the serious complication in the form of carotid artery rupture in the course of repeated radiotherapy.
Material and methods:
The article was written based on the analysis of the literature on the subject from 2009 to 2021.
Results and discussion:
SBRT is relatively safe and effective, especially in those cancers where the survival time with the cancer is relatively long, moreover, the location of the critical organs around the target of the therapy and the dose deposited in the critical organs is important.
Conclusions:
(1) Treatment should be considered for patients receiving treatment more than 2 years after their primary treatment. (2) In cases with a shorter time interval, a minimum of 6 months should elapse before considering SBRT. (3) If feasible, tumor resection should be pursued. (4) In cases of non-resectable tumors, preservation of the functional organ should be a priority.
FUNDING
CONFLICT OF INTEREST
On behalf of all authors, the corresponding author states that there is no conflict of interest.
REFERENCES (34)
1.
Ng SSW, Ning MS, Lee P, McMahon RA, Siva S, Chuong MD. Single–fraction stereotactic body iradiation therapy: A paradigm during the coronavirus disease 2019 (COVID-19). Pandemic and beyond? Adv Radiat Oncol. 2020;5(4):761–773.
https://doi.org/10.1016/j.adro....
2.
Iqbal MS, West N, Richmond N, et al. A systematic review and practical considerations of stereotactic body radiotherapy in the treatment of head and neck cancer. Br J Radiol. 2020;94(1117):20200332.
https://doi.org/10.1259/bjr.20....
4.
Finkelstein SE, Timmerman R, McBride WH, et al. The confluence of stereotactic ablative radiotherapy and tumor immunology. Clin Dev Immunol. 2011:2011:439752.
https://doi.org/10.1155/2011/4....
5.
Mian OY, Hadelsberg U, Gokce K, et al. Reduced lymphocytopenia following stereotactic body radiation therapy (SBRT) for spine metastases compared with conventional radiation therapy (CRT). Int J Radiat Oncol Biol Phys. 2014;90(1):S696–S697.
https://doi.org/10.1016/j.ijro....
6.
Wild AT, Herman JM, Dholakia AS, et al. Lymphocyte-sparing effect of stereotactic body radiation therapy in patients with unresectable pancreatic cancer. Int J Radiat Oncol Biol Phys. 2016;94(3):571–579.
https://doi.org/10.1016/j.ijro....
7.
Ellsworth SG. Field size effects on the risk and severity of treatment-induced lymphopenia in patients undergoing radiation therapy for solid tumors. Adv Radiat Oncol. 2018;3(4):512–519.
https://doi.org/10.1016/j.adro....
8.
Zhang HG, Yang P, Jiang T, et al. Lymphopenia is associated with gross target volumes and fractions in hepatocellular carcinoma patients treated with external beam radiation therapy and also indicates worse overall survival. Can J Gastroenterol Hepatol. 2019;2019:969-1067.
https://doi.org/10.1155/2019/9....
9.
Swain M, Ghosh-Laskar S. Stereotactic body radiotherapy (SBRT) for primary non-metastatic head and neck cancer: When less is enough. Oral Oncology. 2021;116:105265.
https://doi.org/10.1016/j.oral....
10.
Gogineni E, Rana ZH, Vempati P, et al. Stereotactic body radiotherapy as primary treatment for medically unfit patients with head and neck cancer. Int J Radiat Oncol Biol Phys. 2019;105(1):E399–400.
11.
Vargo J, Heron D, Ferris R, et al. Prospective evaluation of patient-reported quality-of-life outcomes following SBRT ± cetuximab for locally-recurrent, previously-irradiated head and neck cancer. Radiother Oncol. 2012;104(1):91–95.
https://doi.org/10.1016/j.rado....
12.
Kawaguchi K, Sato K, Horie A, et al. Stereotactic radiosurgery may contribute to overall survival for patients with recurrent head and neck carcinoma. Radiation Oncology. 2010;5:51.
https://doi.org/10.1186/1748-7....
13.
Siddiqui F, Patel M, Khan M, et al. Stereotactic body radiation therapy for primary, recurrent, and metastatic tumors in the head-and-neck region. Int J Radiat Oncol Biol Phys. 2009;74(4):1047–1053.
https://doi.org/10.1016/j.ijro....
14.
Pfister DG, Ang K, Brockstein B, et al. NCCN Practice Guidelines for Head and Neck Cancers. Oncology (Williston Park). 2000;14(11A):163–194.
15.
Osman SO, de Boer HC, Heijmen BJ, Levendag PC. Four-dimensional CT analysis of vocal cords mobility for highly focused single vocal cord irradiation. Radiother Oncol. 2008;89(1):19–27.
https://doi.org/10.1016/j.rado....
16.
Przeorek W, Składowski K, Przeorek C. Evaluation of treatment results in patients with early glottic cancer (stage T1aN0, T1bN0) treated with Manchester irradiation modality. Współcz Onkol. 2007;11(8):390–394.
17.
Schwartz D, Sosa A, Chun S, et al. SBRT for early-stage glottic larynx cancer – Initial clinical outcomes from a phase I clinical trial. PLoS One. 2017;12(3):e0172055.
https://doi.org/10.1371/journa....
18.
Gowda RV, Henk JM, Mais KL, Sykes AJ, Swindell R, Slevin NJ. Three weeks radiotherapy for T1 glottic cancer: the Christie and Royal Marsden Hospital Experience. Radiother Oncol. 2003;68(2):105-111.
https://doi.org/10.1016/s0167-....
19.
Rudoltz MS, Benammar A, Mohiuddin M. Prognostic factors for local control and survival in T1 squamous cell carcinoma of the glottis. Int J Radiat Oncol Biol Phys. 1993;26(5):767–772.
https://doi.org/10.1016/0360-3....
20.
Biau J, Thivat E, Millardet C, et al. A multicenter prospective phase II study of postoperative hypofractionated stereotactic body radiotherapy (SBRT) in the treatment of early-stage oropharyngeal and oral cavity cancers with high risk margins: the STEREO POSTOP GORTEC 2017-03 trial. BMC Cancer. 2020;20(1):730.
https://doi.org/10.1186/s12885....
21.
Lee D, Kim Y, Cheon J, et al. Long-term outcome and toxicity of hypofractionated stereotactic body radiotherapy as a boost treatment for head and neck cancer: the importance of boost volume assessment. Radiat Oncol. 2012;7:85.
https://doi.org/10.1186/1748-7....
22.
Roh K, Jang J, Kim M, et al. Fractionated stereotactic radiotherapy as reirradiation for locally recurrent head and neck cancer. Int J Radiat Oncol Biol Phys. 2009;74(5):1348–1355.
https://doi.org/10.1016/j.ijro....
23.
Ozyigit G, Cengiz M, Yazici G, et al. A retrospective comparison of robotic stereotactic body radiotherapy and three-dimensional conformal radiotherapy for the reirradiation of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2011;81(4):e263–e268.
https://doi.org/10.1016/j.ijro....
24.
Kress M-AS, Sen N, Unger KR, et al. Safety and efficacy of hypofractionated stereotactic body reirradiation in head and neck cancer: long-term follow-up of a large series. Head Neck. 2015;37(10):1403–1409.
https://doi.org/10.1002/hed.23....
25.
Comet, B, Kramar, A, Faivre-Pierret M, et al. Salvage stereotactic reirradiation with or without cetuximab for locally recurrent head-and-neck cancer: A feasibility study. Int J Radiation Oncol Biol Phys. 2012;84(1):203–209.
https://doi.org/10.1016/j.ijro....
26.
Mantel F, Flentje M, Guckenbergeret M. Stereotactic body radiation therapy in the re-irradiation situation – a review. Radiat Oncol. 2013;8:7.
https://doi.org/10.1186/1748-7....
27.
Hanna GG, Murray L, Patel R, et al. UK consensus on normal tissue dose constraints for stereotactic radiotherapy. Clin Oncol. 2018;30(1):5–14.
https://doi.org/10.1016/j.clon....
28.
Bentzen SM, Constine LS, Deasy JO, et al. Quantitative analyses of normal tissue effects in the clinic (QUANTEC): An introduction to the scientific issues. J Radiat Oncol Biol Phys. 2010;76(3 Suppl): S3-9.
https://doi.org/10.1016/j.ijro....
29.
Vargo J, Moiseenko V, Grimm J, Caudell J, Clump D, Yorke E. Head and neck tumor control probability: Radiation dose volume effects in stereotactic body radiation therapy for locally recurrent previously-irradiated head and neck cancer: Report of the AAPM Working Group. Int J Radiation Oncol Biol Phys. 2021;110(1):137e146.
https://doi.org/10.1016/j.ijro....
30.
Matsushita H, Jingu K, Umezawa R, et al. Stereotactic radiotherapy for oligometastases in lymph nodes — a review. Technol Cancer Res Treat. 2018;17:1533033818803597.
https://doi.org/10.1177/153303....
31.
Yamazaki H, Ogita M, Himei K, et al. Carotid blowout syndrome in pharyngeal cancer patients treated by hypofractionated stereotactic re-irradiation using CyberKnife:A multi-institutional matched-cohort analysis. Radiother Oncol. 2015;115(1):67–71.
https://doi.org/10.1016/j.rado....
32.
McDonald M, Zolali-Meybodi O, Lehnert S, et al. Reirradiation of recurrent and second primary head and neck cancer with proton therapy. Int J Radiat Oncol Biol Phys. 2016;96(4):808–819.
https://doi.org/10.1016/j.ijro....
33.
Gebhardt B, Vargo J, Ling D, et al. Carotid dosimetry and the risk of carotid blowout syndrome after reirradiation with head and neck stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2018;101(1):195–200.
https://doi.org/10.1016/j.ijro....
34.
Ward M, Lee N, Caudell J, et al. A competing risk nomogram to predict severe late toxicity after modern re-irradiation for squamous carcinoma of the head and neck. Oral Oncol. 2019;90:80–86.
https://doi.org/10.1016/j.oral....